Pushing forward public mental health agenda and promotion of mental health
Authors: Danuta Wasserman, Celso Arango, Andrea Fiorillo, Saul Levin, Andrew C. Peters, G. Prasad Rao, Aida Sylla, Thelma Sanchez‐Villanueva
Journal: World Psychiatry (2023)

Major activities are needed to transform psychiatric and mental health care as well as public mental health to deliver on the United Nations (UN) Sustainable Development Goals (SDGs)1. We must ori­ent our services towards sustainable and inclusive prevention, early intervention, treatment, care and rehabilitation, as well as manage social changes and threats while fostering transparency and continuity. As the largest and most important psy­chia­tric organization, with 145 national psy­chia­­tric associations from 121 countries around the entire globe and more than 250,000 members, the WPA has a decisive role to play in this process2. The WPA Planning Committee has identified key priorities for the incoming presidency starting in October 2023 during the World Congress of Psychiatry in Vienna. We are committed to focusing on educational/informational activities directed to psychiatrists, the public, patients and their families, other mental health professionals, and undergraduate and postgraduate students. More importantly, the issue of equal access to mental health care for all should be paramount. To enhance public mental health and well-being as highlighted in Goal 3 (Good health and well-being) of the SDGs, we have prioritized focusing on equal access to psychiatric, mental health, and public mental health services according to the following ranking of the SDGs: Goal 10 (Reduce inequality), Goal 5 (Gender equality), Goal 4 (Quality education), and Goal 17 (Partnerships to achieve the goal). The gaps uncovered by the WPA survey on educational activities3, 4 will be prioritiz­ed. The ambition is to produce and deliver, in the future, educational/informational ma­terials in the six official languages of the World Health Organization (WHO) (Arabic, Chinese, English, French, Spanish and Russian) and hopefully even more. Moreover, to improve the mental health of citizens, and of psychiatric in- and out- patients as well as the psychiatric team that treats them, we need to focus on healthy life­styles such as physical activity5, eating habits6, behavioural changes7, intellectual stimuli8, workplace satisfaction9, and sleep hygiene10, all of which are critical for the improvement of mental health and prevention of poor mental health. Psychiatry has many excellent evidence-based methods for pharmacological and psy­chotherapeutic treatments. Several universal and selective preventive interventions are feasible and cost-effective, and have shown to prevent poor mental health11. However, the role of healthy lifestyles and behaviour­al changes to improve mental health is under-prioritized. The Planning Committee be­lieves that pedagogically tailored life­style activities will add value to the existing biological and psychological therapies when used daily in psychiatric care. Many individuals suffering from mental health problems have never been exposed or provided with good examples at home or in school on how to choose healthy lifestyles: for example, how to purchase healthy foods, how to plan shopping lists, how to cook and what to do with leftovers. Many also lack information on how to achieve and maintain good sleep and how to plan and use their time depending on the different seasons. This type of important information should align with the traditions and social and economic realities of the individuals involved. Physical activities, even when carried out in small amounts but done for some min­utes daily in the morning, noon and evening, have a positive impact on health5. For psychiatric patients, physical activities performed in groups with psychiatric staff or family or community will not only influence well-being and health, but also the feelings of equality, cohesion, collaboration and mu­tual understanding, and the sense of be­long­ingness, hopefully diminishing the stigma of mental disorders. The lifestyle activities performed togeth­er with patients will most likely assist the phy­sical fitness and healthy lifestyles of psy­chiatrists and other staff. Psychiatrists also need to take care of their own somatic and mental health and working conditions12. There are plans to produce short videos on each of the different lifestyle activities intended to be used in daily psychiatric practice, in conjunction with collection of good examples from the WPA Member Societies. Awareness of the influence of environment and art on mental health should also be increased and incorporated into patients' activities13, 14. The aforesaid good examples – such as having patients take care of flowers and plants in the wards; involving them in gardening and choosing decorative art – will be collected from the WPA Member Societies and disseminated through the WPA channels. All interventions for improving healthy lifestyles should be scientifically evaluat­ed. There are plans for the WPA to pro­vide sci­entific guidance on methodology for de­vel­oping cross-sectional, cohort, and case-control studies as well as randomiz­ed con­trolled trials measuring treatment-related satisfaction and improvement of general and mental health, including psy­chological, social and biological outcomes11. To achieve these goals, we will need ad­vice and increased collaboration with national psychiatric and other medical societies, such as the World Medical Association, the World Pediatric Society, the International Federation of Medical Students Associations, the International Society for Physical Activity and Health, the World Organiza­tion of Family Doctors (WONCA), and oth­er men­tal health associations. This also in­cludes continuous collaboration with the WHO, and patient and family associations. We acknowledge that ongoing activities introduced by former presidents, executive committees, and other committees of the WPA deserve continuous strong support. Of special interest are the activities pursued by the Advisory Committee for Responses to Emergencies (ACRE)15 at a time when there are multiple devastating and life-threatening armed conflicts and wars as well as serious environmentally in­duced humanitarian and health crises that are impacting the mental health of the entire world population.